Most regions expect to have improved performance relative to last year’s actuals. The Midwest region is an exception, and actually budgeted for a decrease over last year. Past issues noted that the Midwest has experienced some struggles—it appears that the budgets also reflect these challenges. Conversely, the Northeast/Mid-Atlantic region expects an increase both year-over-year and month-over-month. Given some strong performance in the region lately, this reflects optimism. It will be critical to note how closely their actual performance comes to their budget, given that many organizations are in fiscal year 2019, and new performance targets likely have been set.

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National Profitability Predictions

Nationally, July is expected to be weaker than June, but is budgeted to improve over 2017. There is a fair amount of spread in the budgeted values, indicating that there is not yet consensus on what next month’s performance is anticipated to be at a hospital level. As with most future profitability predictions, the outlook is generally positive, with only the smallest hospitals expecting a decrease. The median EBITDA improvement expected next month is around 200 basis points nationally. We will continue to monitor the monthly results to see if the actuals meet up to these expectations.

As with the national prediction, almost all bed sizes had an anticipated improvement in EBITDA margin over last year actuals, and are expecting to be slightly lower than last month. Small hospitals are the only exception. These hospitals have been experiencing decreasing volumes over the last several months, which highly impact operations. Medium-to-large hospitals expect to see an improvement over last year, with little change from last month.